Loyola students adapt curriculum to support a healthy planet

The first day of the Climate Change and Human Health elective within Loyola University Chicago’s Stritch School of Medicine was electric. The group of about 15 passionate medical students knew that the health of the planet coincides with the health of people and were eager to learn how they could share what they would learn with future patients.

“At the end of the course, I felt a very strong connection between climate change and medicine,” says Lauren Hekman, who attended the inaugural elective course. “I think the lecture content should be taught to all medical students.”

Integrating climate education into the curriculum of higher education, though not always prioritized, remains an important goal. From corrupted water supplies to future global pandemics, university students need to and want to stay aware of how human-caused climate change affects all areas of life, especially human health. Not offering to teach medical students about how a changing environment influences human health would leave a host of future medical professionals without the complete picture of how their patients and their families are faring, especially as it relates to socioeconomically disadvantaged communities that may face greater harm from environmental issues, such as pollution and disease.

“We decided a for-credit elective would be a great starting place,” says Emma Stewart, who led the Group for Environmental Medicine and Sustainability (GEMS) along with fellow third-year Stritch students Sara Alattar and Christina Rao during the 2021–2022 academic year.
In 2019, first-year medical students at the time, Jannie Bolotnikov, Catherine Pearce, and Isabella Park, started GEMS. They completed the paperwork to form a group on campus, which was made official in March of the following year. They then set out to work towards sustainability goals such as composting, improving waste container labeling, and starting a climate change elective. As future physicians, the founding GEMS members agreed they would have a great deal of influence on patients and the community to share about the seriousness of climate change. “It felt wrong to not use our voice that we have been granted,” Park says. “We felt passionate that this was not an issue that was separate from medicine and the career we were training for—it was all intertwined.”

Stewart, Alattar, and Rao built upon the work of the previous GEMS board and dedicated much of their summer in 2021 to completing the elective curriculum application form and formulating a written argument for why medical students need to learn about the connection between climate change and human health. Dr. Aaron Michelfelder, a professor at Stritch and family medicine practitioner, agreed to be their faculty advisor throughout the process. The previous board had also worked with Dr. Amy Blair, who oversees the elective curriculum for Stritch.

The students devised the structure for the course—ideas for lectures, journals, and graded assignments—and then submitted a syllabus, which was reviewed and approved. To get started, they studied other medical schools’ climate change elective syllabi to nurture ideas of what topics should be covered, ranging from vector-borne diseases to microplastics polluting the ocean. The students found experts from all over the nation to give lectures via Zoom through tireless networking.

The course also set out to further students’ education on structural racism. “Low-income and historically oppressed communities are most impacted by environmental racism, so it’s also a social justice issue,” Stewart says. “People have to be aware of how dire things are to do anything about it.”

Curricular reforms are not a new phenomenon. Since the late 1950s to early 1970s when students advocated for racial and ethnic studies courses, degrees, and departments, students have been influencing what is taught in their own schools. With a supportive faculty, issues like climate change can integrate into the curriculum, even in medical school. “In the sciences, it’s notoriously hard to change the curriculum,” says Demetri Morgan, assistant professor in Loyola’s School of Education, who focuses on student activism and racial and ethnic representation in science, technology, engineering, and math (STEM) fields. Accrediting requirements and the very technical expertise required make changing any part of a medical school curriculum even harder. “To get an elective is a really important feat,” Morgan says.

He added that attracting women and racially and ethnically diverse candidates to the medical field requires more than presenting the practical benefits. These individuals need to hear that they will be able to do more than achieve a high salary. “So if you take an organic chemistry course and wonder how this relates to helping my community improve the water supply or getting lead out of pipes, if that connection is really far for students, then we know that it’s likely to derail them,” Morgan says. “If you have an instructor who is able to help make that connection, then it becomes more tangible.”

And electives can help balance out a technical curriculum, according to Morgan, who opined that courses like the climate change and human health elective could help attract minority groups to the STEM field. The technical fields of study are slower to change their curriculum, but they are starting to. Once they do, they can start to connect science lessons to the real world. “That type of connection is really helpful to attract and retain underrepresented students,” Morgan said.

While making strides toward improvement, Stritch ranked no better than mediocre on the 2022 Planetary Health Report Card, a metric-based tool for evaluating and improving planetary health content in health professional schools, which the GEMS students contributed information to in order to obtain a ranking for Stritch. The official grade Loyola’s medical school received was C- on the basis of things like curriculum and research opportunities. “We presented it to the administration,” Stewart said. “We hope that helps drive improvement for not only addressing climate change in the core curriculum, but also just making it a normal thing to talk about and learn about with regard to research.”

The inaugural Climate Change and Human Health elective already has a waitlist for the next semester. In the 2022–2023 academic year, second-year medical student Amanda Sifferlen will be taking over as education coordinator for GEMS and managing and helping to grow the new elective. Taylor Drew and Iris Dingyuan Sun, fellow second-year students, will also serve on the GEMS board with Sifferlen.

One of Sifferlen’s first courses of action will be to have the elective offered twice a year as a full-year running course, rather than just one quarter. Sifferlen will be evaluating the notes from the pilot course and improving the lectures, journals, and assignments. Finally, she hopes to incorporate climate education more into the general Stritch curriculum and to hold guest lectures for students to voluntarily attend.

Sifferlen spoke passionately about educating medical students on the social impacts of treating patients and holistic care: “Especially at Stritch, we emphasize caring for the whole person and not just seeing them as their disease or diagnosis,” Sifferlen says.

Educating Stritch students about the whole patient, including environmental and social concerns, will ultimately make the students better, more well-rounded physicians, Sifferlen and Stewart agree. As Morgan said, these students rely on the work of their predecessors, who have advocated for change to university-level curricula: “There’s a history on the shoulders of previous generations of activists. Students are able to take some of those strategies and utilize them to change the curriculum in ways that are aligned with their emerging interests and hot button topics.”

Redesigning medical school curriculum to include lessons on climate change not only fascinates Morgan but also is quite an accomplishment for students, creating a new wave of more knowledgeable health care providers.

Read more stories from the Stritch School of Medicine.